Hit Me With Your Best Shot: Long-Acting Therapies to Improve HIV Viral Suppression
Authors: Simeon D. Kimmel, Alysse G. Wurcel
Journal: Annals of Internal Medicine (2023)

Editorials4 July 2023Hit Me With Your Best Shot: Long-Acting Therapies to Improve HIV Viral SuppressionSimeon D. Kimmel, MD, MA, Alysse G. Wurcel, MD, MSSimeon D. Kimmel, MD, MASections of General Internal Medicine and Infectious Diseases, Department of Medicine, Boston Medical Center, and Boston University Chobanian and Avedisian School of Medicine, Boston, MassachusettsSearch for more papers by this author, Alysse G. Wurcel, MD, MSDivision of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, and Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MassachusettsSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-1427 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Suppressing HIV to undetectable levels improves health outcomes for people with HIV and reduces risk for transmission. Yet in 2022, just two thirds of people living with HIV in the United States achieved suppression within 6 months of diagnosis (1). Long-acting injectable antiretroviral formulations reduce the burden of daily medicines and are one strategy to support viral suppression. Interest in long-acting antiretroviral therapy (LA-ART) is high for several reasons, including confidentiality and avoidance of nausea, stigma, and pill burden (2). It may also support people with HIV who face barriers to adherence due to mental illness or substance use disorder ...References1. Centers for Disease Control and Prevention. Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data—United States and 6 Dependent Areas, 2021. HIV Surveillance Supplemental Report. 2023;28. Accessed at www.cdc.gov/hiv/library/reports/hiv-surveillance/vol-28-no-4/index.html on 29 May 2023. Google Scholar2. Mantsios A, Murray M, Karver TS, et al. Efficacy and freedom: patient experiences with the transition from daily oral to long-acting injectable antiretroviral therapy to treat HIV in the context of phase 3 trials. AIDS Behav. 2020;24:3473-3481. [PMID: 32410051] doi:10.1007/s10461-020-02918-x CrossrefMedlineGoogle Scholar3. U.S. Food and Drug Administration. FDA Approves Cabenuva and Vocabria for the Treatment of HIV-1 Infection. 27 January 2021. Accessed at www.fda.gov/drugs/human-immunodeficiency-virus-hiv/fda-approves-cabenuva-and-vocabria-treatment-hiv-1-infection on 27 May 2023. Google Scholar4. Edwards GG, Miyashita-Ochoa A, Castillo EG, et al. Long-acting injectable therapy for people with HIV: looking ahead with lessons from psychiatry and addiction medicine. AIDS Behav. 2023;27:10-24. [PMID: 36063243] doi:10.1007/s10461-022-03817-z CrossrefMedlineGoogle Scholar5. Gandhi M, Hickey M, Imbert E, et al. Demonstration project of long-acting antiretroviral therapy in a diverse population of people with HIV. Ann Intern Med. 4 July 2023. [Epub ahead of print]. doi:10.7326/M23-0788 LinkGoogle Scholar6. Cutrell AG, Schapiro JM, Perno CF, et al. Exploring predictors of HIV-1 virologic failure to long-acting cabotegravir and rilpivirine: a multivariable analysis. AIDS. 2021;35:1333-1342. [PMID: 33730748] doi:10.1097/QAD.0000000000002883 CrossrefMedlineGoogle Scholar7. Christopoulos KA, Grochowski J, Mayorga-Munoz F, et al. First demonstration project of long-acting injectable antiretroviral therapy for persons with and without detectable human immunodeficiency virus (HIV) viremia in an urban HIV clinic. Clin Infect Dis. 2023;76:e645-e651. [PMID: 35913500] doi:10.1093/cid/ciac631 CrossrefMedlineGoogle Scholar8. Linas BP, Cunningham CO. Coronavirus disease 2019 (COVID-19) disparities: a call for equity in health outcomes and clinical research [Editorial]. Clin Infect Dis. 2021;73:e4139-e4140. [PMID: 33111148] doi:10.1093/cid/ciaa1460 CrossrefMedlineGoogle Scholar9. Fletcher L, Burrowes SAB, Khan GK, et al. Perspectives on long-acting injectable HIV antiretroviral therapy at an alternative care site: a qualitative study of people with HIV experiencing substance use and/or housing instability. Harm Reduct J. 2023;20:4. [PMID: 36627679] doi:10.1186/s12954-023-00730-z CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Simeon D. Kimmel, MD, MA; Alysse G. Wurcel, MD, MSAffiliations: Sections of General Internal Medicine and Infectious Diseases, Department of Medicine, Boston Medical Center, and Boston University Chobanian and Avedisian School of Medicine, Boston, MassachusettsDivision of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, and Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MassachusettsDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-1427.Corresponding Author: Simeon D. Kimmel, MD, MA, Boston Medical Center, 801 Massachusetts Avenue, Crosstown Building, 2nd Floor, Boston, MA 02118; e-mail, simeon.[email protected]org.This article was published at Annals.org on 4 July 2023. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDemonstration Project of Long-Acting Antiretroviral Therapy in a Diverse Population of People With HIV Monica Gandhi , Matthew Hickey , Elizabeth Imbert , Janet Grochowski , Francis Mayorga-Munoz , John D. Szumowski , Jon Oskarsson , Mary Shiels , John Sauceda , Jorge Salazar , Samantha Dilworth , Janet Q. Nguyen , David V. Glidden , Diane V. Havlir , and Katerina A. Christopoulos Metrics LatestKeywordsDrug deliveryDrugsHIVInfectious diseasesPrevention, policy, and public health ePublished: 4 July 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...